| Objective: To observe the clinical effect of Yiqi Huoxue Decoction combined with local cold therapy in the treatment of limb swelling before tibiofibular fracture.By analyzing and comparing the changes of soft tissue swelling,pain,clinical effect,blood routine,erythrocyte sedimentation rate,C-reactive protein and hemorheology before and after treatment,to explore the clinical effect of Yiqi Huoxue Decoction combined with local cold therapy in the treatment of limb swelling before tibiofibular fracture,to provide guidance for clinicians to make better decisions in the treatment of limb swelling before tibiofibular fracture,and to provide new ideas for the treatment of limb swelling after fracture with integrated traditional Chinese and western medicine.Methods: From January 2019 to March 2020,160 cases of tibiofibular fractures admitted to the Department of Orthopedics of Xing ’an Jieshou Bone Injury Hospital were selected,which met the inclusion criteria but did not exclude any one of the criteria.Patients were included according to the inclusion criteria and exclusion criteria,and then the patients were divided into 4 groups according to the computer random grouping method: group A:mannitol+cold therapy group,i.e.125 ml of 20% mannitol intravenous drip,bid,topical application with cold therapy device,20 min,bid;Group B:Mannitol+Yiqi Huoxue Cream,i.e.125 ml of 20% Mannitol is given intravenously,bid,and 100 ml of Yiqi Huoxue Cream is given orally in the morning and evening.Group C: Mannitol+Yiqi Huoxue Herbal Paste+cold therapy Group;Group D: mannitol group only.The treatment period is 1week.The following indexes of patients were detected:(1)Hemorheological indexes: 4-5ml of venous blood at left elbow was drawn from 6: 00 to 8: 00 in the morning on the first day of treatment and the 7th day after treatment,and heparin anticoagulation tube was added to shake well.The blood was sent to the laboratory to be detected by using the same fully automatic hemorheological analysis instrument.The main indexes were plasma viscosity,low,medium and high shear viscosity of whole blood,etc.(2)Inflammation-related indicators: White blood cells,erythrocyte sedimentation rate,C-reactive protein and other indicators were drawn on the 1st and 7th days after treatment.(3)swelling relief: measure the swelling degree of the affected limb before treatment and on the 1st,3rd,5th and 7th days after treatment with a soft ruler.(4)Pain score(VAS score): Assess the pain score of affected limb before and on the 1st,3rd,5th and 7th days after treatment.(5)The time when dermatoglyphics first appeared.(6)Number of complications.The data were statistically analyzed by SPSS 20.0 software.Results: 1.The four groups of patients had no statistical significance(P >0.05)in baseline data such as gender,age,side,injury factors,swelling degree of affected limb,fracture classification,etc.,and were comparable.2.after receiving treatment for 7 days,the total effective rate of the four groups of patients is 100%,which shows that the four treatment methods can achieve the therapeutic effect.however,from the aspect of effective effect,it can be seen that the treatment method adopted by group c is better than that of the other three groups(p < 0.05).group a and group b are also better than the control group(p < 0.05),but there is no obvious difference in clinical efficacy between group a and group b(p > 0.05).3.compared with the other three groups in hemorheology,the indexes in group c decreased most obviously after receiving treatment,and the difference was statistically significant(p <0.05).Compared with the control group,each index of the other three groups decreased more significantly,and the difference was statistically significant(p< 0.05).4.in terms of inflammation-related indicators,c-reactive protein,L-1β,IL-6,TNF-α and erythrocyte sedimentation rate were significantly decreased before and after treatment in the four groups,and the indicators in group c were significantly decreased,with significant differences compared with other three groups(p < 0.05).Compared with the control group,each index of the other three groups decreased more significantly,and the difference was statistically significant(p < 0.05).5.compared with the control group,the swelling values of the affected limbs showed an upward trend on the 1st and 3rd days.compared with the control group,the swellingvalues of the other three groups showed a smaller increase,with statistical significance(p < 0.05).the swelling values of group c showed a smaller increase than that of group a and group b,with statistical significance.On the5 th day and 7th day,the swelling values began to decrease.the decrease values of group a,b and c were significantly lower than those of the control group,while group c decreased the most and was higher than the other three groups,with statistically significant difference(p < 0.05).6.in terms of VAS scores,there was no significant difference in pain VAS scores among the four groups when the patients were admitted to hospital(p < 0.05).after corresponding treatment,the pain VAS scores of each group gradually decreased.The pain VAS scores of group a,group b,and group c decreased significantly higher than those of control group on the 1st,3rd,5th,and 7th days,while the pain VAS scores of group c decreased faster than those of group a and group b,while the pain vas scores of group b decreased faster than that of group a,with statistically significant differences(p < 0.05).7.comparing the occurrence time and complications of dermatoglyphics,the occurrence time of dermatoglyphics was the latest in the control group and the earliest in group c,followed by group b and group a.there were significant differences among the four groups,with significant statistical significance(p< 0.05).In this study,tension blisters were the most common complications in the four groups,and gastrointestinal discomfort occurred in groups B and C.Conclusion: Yiqi Huoxue Herbal Paste combined with cold therapy has aclinical effect of accelerating blood circulation of soft tissue at the affected part,promoting swelling to subside and possibly relieving soft tissue pain,which can provide a certain reference basis for clinical solution of soft tissue swelling before tibiofibular fracture surgery.Traditional Chinese medicine ointment combined with cold therapy can be used as the first choice for the treatment of preoperative soft tissue swelling after trauma,which is worthy of further research and application. |
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